How quickly could my labs go out of range or ev... - Thyroid UK

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How quickly could my labs go out of range or even HYPER thyroid?

kinoble profile image
61 Replies

Hi guys,

Loadsa questions lately from a practical pov for people who have been through treatment, so I apologise!

As posted the other day my last labs BEFORE I started taking Armour Thyroid a week ago were:

Free T3- 6.0 pmol/L. (3.1-6.8)

Free T4- 17.6 pmol/L (12-22)

TSH- 2.71 miU/L (0.27-4.2)

So on a dose of 30mg Armour a day, soon to go up to 60mg as a split dose (good idea or too quick??) within a week, hypothetically how long would it take to bring my TSH down to say 1.0, or on the other hand go HYPERthyroid?

I read somewhere and it worried me that someone started taking 60mg and went HYPERthyroid and subsequently.developed dvt/clots because of the effects on coagulation. Has anyone experienced/heard of this?

Many thanks

B

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kinoble
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61 Replies
Aurealis profile image
Aurealis

I thought dvt / clots would be more likely with under treatment of hypothyroidism due to slowed heart rate and a general slowing down leading to less exercise, more sleep etc, all risk factors for dvt

It is difficult to do things slowly but very unpleasant if you raise too quickly and difficult to anticipate due to delayed effect of rising T4 and difficulty in reducing quickly due to long half life of T4

kinoble profile image
kinoble in reply toAurealis

Hi Aurealis,

Agreed, if is as far as I know for the exact reasons you said. However apparently changes to fibrin and coagulation due to increased hormone to treat hypothyroid can be a risk too. Especially if t4 or rt3 gets too high. Typically I think it's more associated with Hypo, however I have read (journals and anecdotal) of both.

Aurealis profile image
Aurealis in reply tokinoble

I'm interested in this, having had a dvt at a time when I wasn't feeling hypo. I'd never heard of that - do you have any references?

kinoble profile image
kinoble in reply toAurealis

ncbi.nlm.nih.gov/pubmed/223...

One of a few.

Did u have symptoms of.clots?

Aurealis profile image
Aurealis in reply tokinoble

Thanks, hence the association between suppressed TSH and critical events requiring hospital admission.

Yes I did have symptoms, most predominantly leg pain

kinoble profile image
kinoble in reply toAurealis

Indeed. Interesting. Leg pain different to a bad strain?

Do.you know what your labs were then out of interest?

Aurealis profile image
Aurealis in reply tokinoble

Sharp localised pain in my case

kinoble profile image
kinoble in reply toAurealis

Did the pain continue at rest/in bed (I.e. no activity?)

Were any other hormones involved? I.e. if pill taken did they blame.it on that? Feel free not to answer!

Aurealis profile image
Aurealis in reply tokinoble

I'll send you a private message

kinoble profile image
kinoble in reply toAurealis

Thanks!

QUE6T-33 profile image
QUE6T-33 in reply toAurealis

Suppressed TSH & critical events, would that

be associated also by elevated FT4 / FT3 ?

kinoble profile image
kinoble in reply toQUE6T-33

Not sure if thats aimed at me but frm what I have read, yes.

And elevated rt3 can also have dire consequences.

QUE6T-33 profile image
QUE6T-33 in reply tokinoble

Only asked because since on meds

my TSH has suppressed, but my other

levels aren't even optimal yet.

kinoble profile image
kinoble in reply toQUE6T-33

I'm.not qualified as a newbie but maybe suggestive of sub-optimal.dose? Too high or too low? Maybe someone better informed can help?

QUE6T-33 profile image
QUE6T-33 in reply tokinoble

Yep, too low - I'm working on it.

Aurealis profile image
Aurealis in reply toQUE6T-33

TSH can become suppressed very readily by any ingested thyroid hormone. Therefore for many people cannot reliably be used to inform optimal treatment.

QUE6T-33 profile image
QUE6T-33 in reply toAurealis

Yep, that was my understanding. So

the suppressed TSH & critical events

comment above perhaps more readily relates elevated FT4 or more likely FT3.

Aurealis profile image
Aurealis in reply toQUE6T-33

Sadly I don't think so. I think that Diogenes has posted references about this on this site. Perhaps someone can give you a reference? Perhaps Helvella can help?

QUE6T-33 profile image
QUE6T-33 in reply toAurealis

Thanks Helvella - yes please could

someone let me know where I can

read up in this please. Ta x

QUE6T-33 profile image
QUE6T-33 in reply toAurealis

Hi Aurealis - could you offer any

Ideas on how I could locate this

link please ?

Aurealis profile image
Aurealis in reply toQUE6T-33

I started a new thread - let's see what response there is. Sorry, I read all this stuff but don't keep links and addresses so I can get back to it.

QUE6T-33 profile image
QUE6T-33 in reply toAurealis

Oh, magic. Thanks for that as real

interested. Bye for now

Aurealis profile image
Aurealis in reply toQUE6T-33

Not necessarily. If you trust TSH test, suppression means over treatment. The key is to have fT3 and fT4 in the correct place on the range for your own individual set point, not anywhere in the range.

SAMBS profile image
SAMBS in reply toAurealis

Thats what i had for a few weeks before my aneurysm, pain was in left groin! Was put on Kardegic (warfarin) in hospital, should still be taking it but dontfor variety of reasons.

QUE6T-33 profile image
QUE6T-33

Hi - your lab results prior starting Meds don't look that bad to me ! ?

kinoble profile image
kinoble in reply toQUE6T-33

Hi Quest,

I agree. It's not so much my labs, however my TSH has been averaging 3.47 and higher.

It's more my symptoms.

I have been house/bedbound after given a diagnosis of CFS 4 years ago. Used to be a gym manager and amateur powerlifter and natural bodybuilder prior to this.

My specialist Dr thinks that I may have an issue with rt3 which is not part of the standard tests.

I have been put on the thereputic dose above and seen 20%+ improvements in a week

Which is utterly remarkable when I have tried EVERYTHING in 4 years. Also I believe my extreme.dieting caused a hypothyroidism issue initially and that was misdiagnosed as CFS. I may be wrong, but I'm hopeful.

As you know the NHS tests do not tell the full story.

B

cc120 profile image
cc120 in reply tokinoble

I think my anorexia started off my health problems including hypothyroid.

kinoble profile image
kinoble in reply tocc120

Yep...diet or lack of wreaks havoc.on your thyroid.

Aurealis profile image
Aurealis in reply toQUE6T-33

I wonder how reliable tests are, they can be so variable at different times of day due to diurnal cycle and also are affected by other illness, so high T3 can be associated with general illness/ infection can't it. I had cfs once and I think this was the beginning of my hashimotos when I may have had thyroid levels that were too high - hair loss, weight loss and chronic fatigue

kinoble profile image
kinoble in reply toAurealis

I know for a fact they ARNT always reliable or at least consistent. as.my wife is hypo, and one test came.back 2.4tsh and the other two tests over 5.5. Taken at the same time, same place. With no medication to explain the changes.

Aurealis profile image
Aurealis in reply tokinoble

How come she had three together, I've always wanted to do that to prove to them that the tests isn't reliable

kinoble profile image
kinoble in reply toAurealis

She had one at 5.5, wasn t prescribed anything (Dr wasn't convinced)/continued having symptoms so had a repeat 6(?)/weeks later and it was around 2.5, my wife was not.convinced so had it again the next day I believe, same time etc and it was above 5 again!

Went on levotheroxine.

QUE6T-33 profile image
QUE6T-33 in reply tokinoble

Interesting. Were these bloods in NHS

kinoble profile image
kinoble in reply toQUE6T-33

Yep NHS bloods. Hence no rt3. That's privately being done next week.

Hi Kinoble,

Looking at your blood results before you started taking armour I would question whether you are hypothyroid at all.

Your TSH is raised but your FT4 and FT3 are good.

Maybe you should check all vitamin and minerals especially ferritin looking at areas that might contribute to your CFS.

I would tread very carefully with the Armour. Don't raise to 1 grain yet.

The TSH does go up and down throughout the day and is also affected by our health, viruses etc.

I will be very interested to see what other have to say but with your FT figures I would suggest you proceed cautiously with medication.

Hyperthyroid is a dreadful feeling and you really don't want to go there!

kinoble profile image
kinoble in reply to

Hi Joesmum,

Like.I mentioned above it was based on my symptoms. Not the NHS approach.

My Ferritin, b12 etc has all been normal.in range and actually at the upper end of the reference ranges.

I have had every single hypothyroid symptom you can have over 4 years, and 30mg supervised by my Dr has given me 20% improvement in 7 days.

By all accounts the normal.tests do not tell the full story but I am keen for any enlightenment :)

Thanks for your reply,

B

Aurealis profile image
Aurealis in reply tokinoble

I'd advise you to go slowly so you don't lose the gains you've made. Perhaps you could use your 20% improvement to do something that would help a bit more

kinoble profile image
kinoble in reply toAurealis

Sure thing. Well I have already been on a couple of walks. Yea, they have only been a mile.or more but that would have not been possible a.week ago. Not a chance.

Aurealis profile image
Aurealis in reply tokinoble

That's brilliant. Think of it as the beginning of a chain of events that'll lead to you feeling better. A mile sounds a long way with cf

kinoble profile image
kinoble in reply toAurealis

It's is massively!!! 5% is a big deal let alone 20+.

in reply tokinoble

Ok, if you're feeling a slight improvement, stick with it. But don't be tempted to raise your dosage. Your FT3 is good in range and adding 30mcgs of armour will increase it further but you DO NOT want to go over range.

Thyroid medication is not a quick fix cure.

As clutter constantly reminds us symptom relief can lag behind good blood results by a few weeks.

If you are already feeling an improvement then stick where you are.

Just don't want you to go over. It's seriously unpleasant.

kinoble profile image
kinoble in reply to

Great advice thank you.

That's the whole point of my question- I DONT want to go HYPERthyroid hence why I am.asking and being tentative with dosages.

I'm not saying its the cure for me, however if it wasn't part of it surely i wouldn't have responded so well? Within a few.days?!

My Dr (Sarah Myhill) believes that I perhaps do not have enough active t3 getting into my cells.

Interestingly as well my spo2 levels have gone from.94-96/98% since taking the hormone. I might start a thread on that but I suspect it's implying better cellular function /oxygen.

in reply tokinoble

T4 takes about 6 weeks to metabolise and T3 takes about 3 days.

The improvement you're feeling must be the T3 as its too soon for the T4.

In other words I would recheck blood levels 5/6 weeks after starting 30mcgs.

If you do raise to 1 grain you will know pretty quickly if you've gone over.

You may feel anxious, jittery, panicky, hot, nauseas, headachy.

If you do want to raise then no more than 1/4 grain at a time.

But truthfully I would stick where you are and wait for it to work at a cellular level which as I say takes about 6 weeks.

kinoble profile image
kinoble in reply to

Perfect. Thanks for this.exactly what I needed!

My specialist GP did recommend.armour OR pure T3 so maybe the pure T3 would be a better long.term.bet.

in reply tokinoble

Give the armour chance to work fully before switching meds.

You may find it suits you and if it does- stick with it.

kinoble profile image
kinoble in reply to

Yep I will do. That's the advice I was given the other day too. The only worry was my T4 going over range...and making the rt3 issue worse of I'm.not converting properly.

Also...what would my bloods look.like.for typical HYPERhyroid?

in reply tokinoble

Highly unlike that your ft4 will go over range.

More likely FT4 will DROP in range as the TSH will detect the T3 in the system and shut down its own production of T4 thinking it has no reason to produce it. Hope that's clear.

kinoble profile image
kinoble in reply to

So really I just need to be mindful.of symptoms, and TSH level?

in reply tokinoble

Precisely.x

QUE6T-33 profile image
QUE6T-33 in reply tokinoble

What is spo2?

kinoble profile image
kinoble in reply toQUE6T-33

Sorry-blood oxygen levels. Above 95 is considered normal. 97+ optimal (by most).

kinoble profile image
kinoble

P.s. you guys are.awesome. and so helpful. It's much appreciated.

kinoble profile image
kinoble

Also while on topic....of it is the t3 in armour helping me should in split my 30mg dose into 2x15mg? Or not bother? I know the half life is short.with t3 hence my reasoning. Also best time to take ?

Aurealis profile image
Aurealis in reply tokinoble

Yes two doses would be better, for the reason you've given above

kinoble profile image
kinoble in reply toAurealis

Early morning and afternoon? Specific times?

Thanks A!

Aurealis profile image
Aurealis in reply tokinoble

Depends who replies. Some will say breakfast and lunch, some go 8am 2am, others avoid taking with food. I'd say fit it in your lifestyle, you can always amend later

kinoble profile image
kinoble

Awesome. Pretty much what I'm doing now!

Thanks A!

Glynisrose profile image
Glynisrose

Your doctor will declare you hyperthyroid if your TSH is suppressed lots of people feel much better with a suppressed TSH which is actually a pituitary hormone NOT a thyroid hormone.

SilverAvocado profile image
SilverAvocado

Kinoble , sounds like you and I had a similar level of mobility problems. I'm curious about whether you've managed to do any regular exercise or stretching?

I also used to be very active, and been been mostly in the house the past 2.5 years. I really regret seeing my flexibility reduce, posture get worse, et, so determined to get something regular going this Autumn. Very had to set the bar gentle enough :)

kinoble profile image
kinoble in reply toSilverAvocado

Hey SA,

I've had periods of gentle stretching but generally no. Yoga has been out. However since last week I could.probably do a little yoga session now, which is a.massive improvement.

I think you are right, its.about expectation and where to set the bar. Exercise for me now is a.little.walk, whereas before that would have been just something everyone does each day!!!

Fatigue on a cellular level is hard for a lot of people to understand. My tiredness is not sleepy, its sheer exhaustion like I have just run a marathon every single day, and where sleep, supplements rest and diet do not help. 30mg Armour has. Only thing in 4 years. But then the thyroid governs a huge amount in terms.of cellular function, use of energy and metabolism it makes sense. NHS labs not so much. B

trevg profile image
trevg

It does seem to me that in all these comments the only constant seems to be that RT3 is indicating something wrong, somewhere. I

have had TSH levels between 3 & over 5 -whilst RT3 has been measured once at around 90% of range during this period, approx twice as high as optimal from all I've read.

This was a private test last year- but was enough to gain my conviction that Sub Clin HypoT was a 'get out' diagnosis in the NHS.

I now have the go ahead to start T3 -as T4 did me in, no mistake.

This is a rare event and I will update in a new thread, when I commence.

I also await a check out Diurnal Cortisol test result from Biolab, done in the US to make sure I'm not way out on adrenals. NHS does not use this useful test.

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